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General NPI Number Information
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NPI Number | 1477969749
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Entity Type | Organization
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Legal Business Name | CANDLER ENT PRACTICE, LLC
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Dates
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Enumeration Date | 07/08/2014
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Last Update Date | 10/24/2019
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Provider Practice Location Address
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Address Line | 5356 REYNOLDS STREET SUITE 505
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City | SAVANNAH
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State | GA
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Zip | 31405
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Country | US
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Telephone | 912-356-1515
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Fax | 912-644-0756
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Provider Business Mailing Address
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Address Line | 836 E. 65TH STREET SUITE 22
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City | SAVANNAH
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State | GA
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Zip | 31405
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Country | US
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Telephone | 912-819-7878
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Fax | 912-819-3555
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Authorized Official
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Title or Position | PRESIDENT/ CEO
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Name | MR. PAUL P HINCHEY
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Credential |
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Telephone | 912-819-9601
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 231H00000X
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Taxonomy Name | Audiologist
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License Number | AUD003814
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License Number State | GA
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Taxonomy #2
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Taxonomy Code | 207Y00000X
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Taxonomy Name | Otolaryngology Physician
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License Number | 025161
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License Number State | GA
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